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NPI Code Detail

MEDICARE: MR. ROBERT C ERVIN ENP, CRNA

MEDICARE: MR. ROBERT C ERVIN ENP, CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse AnesthetistAP113789TX

General Provider Information

NPI Number : 1689673162
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ROBERT C ERVIN ENP, CRNA
Provider Business Mailing Address
First Line : PO BOX 844658
Second Line :
City : DALLAS
State : TX
Zip : 75284-4658
Country : US
Telephone Number : 254-724-2111
Fax Number :
Provider Business Practice Location Address
First Line : 700 SCOTT AND WHITE DR
Second Line :
City : COLLEGE STATION
State : TX
Zip : 77845-6441
Country : US
Telephone Number : 254-724-2111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2005
Last Update Date : 11/07/2025

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